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For Roger Gorman’s father in law, it was books, newspapers, plastic grocery bags and leisure magazines.

“There must have been over 2,000 magazines in his apartment,” says the 53 year old graphic designer from Manhattan. “There were stacks and stacks of them, columns of them.

But thanks to new research, the cluttered, confusing world of the compulsive hoarder may finally be starting to sort itself out.

In a recent study conducted by Dr. Sanjaya Saxena, director of the Obsessive Compulsive Disorders Program at the University of California, San Diego, 20 adults with clinically significant compulsive hoarding issues and 18 healthy non hoarding controls were given PET scans to measure their brain metabolism. Hoarders were found to have lower activity in a specific part of the brain that’s involved in decision making, focused attention and the regulation of emotion.

“We found that patients with compulsive hoarding had a unique pattern of brain function abnormalities,” says Saxena, whose study is currently undergoing pre publication review. “This pattern was not seen in other OCD patients, nor in the normal controls. It looks like compulsive hoarding is truly a distinctive diagnostic category, which has big implications for both diagnosis and treatment.”

Saxena says these findings may pave the way for future studies on medication and other treatments that can increase the activity in this particular part of the brain and regulate the impulses that make hoarders save and acquire excessively.

In the meantime, therapy offers hope on another front.

In a July 2007 study in the British journal Behaviour Research and Therapy, 10 compulsive hoarders underwent cognitive behavioral therapy, which included 26 individual sessions and frequent home visits. Following seven to 12 months of treatment, 50 percent had “very much improved” when it came to classic hoarding behaviors like the clutter, excessive acquisition and the inability to discard.

These new findings hold promise not just for hoarders but for exasperated friends and family members who are both baffled and burdened by their loved ones’ compulsions to stockpile newspapers, magazines, junk mail, plastic sacks full of unworn clothing, broken appliances, animals, even rotting food.

“My father in law is a really intelligent guy,” says Gorman, who was completely taken aback by the “Aladdin’s cave” of possessions he found when his wife’s dad was unexpectedly hospitalized. “He’s healthy and active, he still works and is constantly reading and learning. But he can’t throw anything away.”

Maureen Brown of Pacific Grove, Calif., is similarly perplexed by her mother in law’s hoarding, which has prompted multiple family interventions.

“My husband and I have cleaned up her place probably eight times,” says the 27 year old daughter in law. “We’ve taken multiple truck loads to the county dump and had at least five separate garage sales. There was so much mail she hadn’t opened. We found tons of foreclosure notices, shut off notices from the electricity company.

Compulsive hoarders are different from die hard collectors or “clutter bugs” in that they can’t stop acquiring things nor can they make themselves throw anything away. In addition to eBay bargains and department store finds, they’ll keep items that are completely useless to them like old newspapers and burned out light bulbs and collect so much of it that it interferes with their basic ability to function. They can’t cook a meal, eat off the table, sleep in their bed or worst case scenario walk through their house without a tremendous amount of difficulty (in extreme cases, homes will have “goat paths” through towering piles of junk).

Not that hoarders see the situation they’re living in. According to Frost, many of his patients are “blind to the clutter” and will deny it’s their mess even when shown pictures of their own homes during therapy. They’ll also buy presents for people then forget to give them or “file” electricity bills on a pile with clothes, computer parts and canned corn due to an inability to focus attention and properly categorize.

“Hoarders have a fundamental inability to keep things organized,” says Frost. “Not just their possessions, but other things, like finishing tasks. We see a lot of attention deficit problems in hoarding.”

To complicate matters further, hoarders seldom stop hoarding without treatment, yet many refuse to seek help or recognize that they need it and become extremely antagonistic if others try to clean out their homes.

Elise Davis, 41, of Seattle, says her grandmother is in “total denial” about her hoarding problem even though the 86 year old’s spare bedrooms are crammed to capacity and her kitchen drawers are jammed shut with “those little free packets of jam you get from Denny’s.”

“She’s gets really feisty if you try to approach her about it,” says Davis. “You can’t even clean up a pile of paper because she’s petrified that you’re going to get rid of something that she needs, even though it’s all just packets of jam and $4 half slips from Penneys and geology textbooks from when my mom was in high school.”

Maureen Brown, who recently moved her 65 year old mother in law into a condo (the bills all go to Brown and her husband), has also encountered resistance.

“My mother in law is still employed and has good health insurance and could get her counseling paid for, but she won’t go,” she says. “She feels it’s her right to collect as much stuff as she wants and refuses to acknowledge that it’s a problem.”

In January 2006, a 62 year old woman from Shelton, Wash., suffocated under a pile of clothing in her debris filled home. In July of that same year, 14 firefighters were injured while putting out a three alarm apartment fire in Queens that was classified a “Collyers’ Mansion,” named for the infamous brothers who, in 1947, suffocated and/or starved in a Harlem brownstone filled with more than 120 tons of floor to ceiling clutter.
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